EADO 2023 | Nodal MCC with unknown primary site and no distant metastasis: a challenging entity

Nicola Fazio, MD, PhD, European Institute of Oncology, Milan, Italy, discusses the challenges of Merkel cell carcinoma (MCC). MCC can present as an unknown primary or nodal MCC without a visible skin site or distant metastasis. This is a rare condition, accounting for less than 15% of MCC cases overall but up to 40% in regional MCC. Dr Fazio highlights the need for clinicians to be aware of this entity, which is more associated with neuroendocrine cancer than skin cancer. Differential diagnosis is challenging based on morphological features alone, requiring immunohistochemistry for confirmation. A single-center study of 55 cases revealed favorable outcomes with lymphadenectomy and adjuvant radiotherapy, achieving a five-year cancer-specific survival rate of 70%, and up to 90% when both treatments were administered. Defining clear treatment guidelines for this clinical entity remains a challenge, but curative approaches yield promising results. This interview took place at the EADO 2023 congress.

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